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Drug / Biological

J3420 Medicare Reimbursement Rate (2026)

Current CMS pricing and breakdown for Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg.

HCPCS Code J3420National Fixed Rate

National Average Payment

Non-Facility (Private Office) Rate

$0.64
Effective Jan 1, 2026

ℹ️ Good to Know

This item has a standard price nationwide. Your local rate will likely match the amount shown above.

Code Description

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

Local Estimate Demo

Pick a demo zip (or type yours) and choose the setting. Then jump into MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool to calculate your locality-adjusted estimate.

Using: New York, NY
Prefill target zip: 10001
This pre-fills the homepage tool with your code, zip, and setting.

How is this calculated?

Here’s the transparent math behind the estimate for HCPCS Level II code J3420. For locality-adjusted results, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.

Methodology

This code is paid using: Average Sales Price (ASP) + 6%.

This item is typically standardized nationally, but coverage and claim details can still affect final payment.

Open MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool
Note: This page shows national estimates and methodology. Final reimbursement depends on locality, place of service, coverage rules, modifiers, and payer policy.

Reimbursement Summary

The 2026 National Medicare reimbursement for J3420 is $0.64. This item is paid at a standard national rate, so local variation is typically minimal.

Description: Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg. Payment policies and coverage rules can still vary by setting and claim details, so confirm final guidance through CMS when needed.

Note: amounts shown are estimates based on CMS national averages for 2026. Final payment depends on locality, setting, and claim details.

Facility vs. Non-Facility (Office) Payment

Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For J3420 (Drug / Biological), the payment methodology may not include both facility and non-facility rates.

2026 Breakdown

ComponentOffice (Non-Fac)Facility (Hosp)
Work RVU
Practice Expense (PE)
Malpractice (MP)
Total RVUs0.000.00

Historical Medicare Reimbursement

2022202320242025
YearNon-Facility RateFacility RateYear-over-Year % Change
2026Coming Soon (Pro)Coming Soon (Pro)Coming Soon
2025Coming Soon (Pro)Coming Soon (Pro)Coming Soon
2024Coming Soon (Pro)Coming Soon (Pro)Coming Soon
2023Coming Soon (Pro)Coming Soon (Pro)Coming Soon

Historical trends and quarterly breakouts are launching as part of Pro. This preview shows where multi-year analytics will appear once the full dataset is available.

Pro includes historical graphs, deeper year ranges, and export tools. Learn more and join early access.

View Pro Plan (Coming Soon)

Learn How This Reimbursement Is Calculated

Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.

Frequently Asked Questions

What is the 2026 Medicare rate for J3420?

The 2026 National Average Medicare reimbursement rate for J3420 (Drug / Biological) is $0.64. This rate is effective as of January 1, 2026.

What is the description for code J3420?

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

Why do facility and non-facility payments differ for J3420?

Facility vs. non-facility differences usually apply to RVU-based physician services. J3420 may not use both facility and non-facility pricing depending on its payment methodology.

How can I find my local Medicare rate for J3420?

Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.

Is J3420 covered by Medicare?

Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.